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School-Based Services

School districts can receive Medicaid reimbursement for health-related services provided to special education students, but they don't often have the internal resources needed to claim those reimbursements. We developed an online application that allows Medicaid providers to complete time studies, document the delivery of health-related services, and submit claims electronically. Our web-enabled school-based claiming application currently supports over 2,500 school districts in 9 states, as well as various state and local agencies.

Since implementing our school-based claiming system in 1996, we have helped local governments in multiple states secure more than $1 billion in federal reimbursement. Our services include:

Random moment time studies (RMTS): We were one of the first organizations to provide RMTS to school districts. We now serve over 15 RMTS entities throughout six states, totaling 1,227 clients.

Direct service claiming: We enable school districts to obtain reimbursement for allowable direct health care services provided to students.

Cost report reconciliation: Using time study data as required by CMS, we enable school districts to obtain reimbursement for allowable direct health care services provided to students through a certified cost report.

Administrative claiming: Using required time study data, we enable school districts to obtain reimbursement for allowable Medicaid-related administrative services provided to students and their families.

Training: We provide in-person and online training to your staff so that they can easily complete the requirements for reimbursement.

Capabilities include:

Easily customizable system to support an individual district/agency’s needs

Experts

Related Work

This report provides a snapshot of the innovative programs UMass Medical School’s Center for Health Care Financing has initiated and conducted on behalf of the Commonwealth of Massachusetts.

You will see how we have been able to generate revenue and achieve cost avoidance totaling $26 billion over the past 15 years. And while the numbers are impressive, especially in increasingly difficult fiscal times, the more important story is what can be accomplished when the family of state agencies in Massachusetts collaborate and combine their strengths to better serve the public.

Related Information

Our team focuses on meeting the needs of people with disabilities from birth through the end of life, particularly issues concerning health, safety and employment, as well as supporting access to community-based long term services and supports.

Children are one of our most vulnerable populations, and can have special health care and support needs because of complex medical conditions or disabilities. We help families, and the children they care for, access the most appropriate health care services and supports for their needs – regardless of health conditions, age, or family circumstances.

Unraveling the complexities of Medicare, Medicaid, and other agencies and programs is not easy. We work with states across the country to maximize federal reimbursement and reclaim revenue owed to state agencies and localities.